1169 Assessing the role of race in contraceptive counseling and postpartum contraceptive attainment

Abstract

Healthcare workers must be cognizant of patient characteristics that make them vulnerable to reproductive coercion. This analysis follows a major institutional campaign to increase rates of prenatal contraceptive counseling (CC) and access to contraception, including long-acting reversible contraception, during the delivery hospitalization. Given known healthcare disparities and increased maternal mortality in women of color, rates of prenatal CC reported by black women and their ability to obtain desired contraceptive plans were assessed. Using an existing quality improvement data set, a retrospective review identified women who delivered at our institution over a 6-month period in 2018-2019. Patients were stratified by self-reported race (Black vs White vs Other Race/Biracial). Rates of reported prenatal CC, change in planned contraceptive method and attainment of desired contraceptive method were assessed using Chi square and student t-tests where appropriate. 2027 charts were reviewed with 1646 (81.2%) identifying as White, 127 (6.3%) identifying as Black, and 254 (12.5%) identifying as other race/Biracial. Data is presented in the table. Black and other race/Biracial/Other women reported significantly less CC, than White women (p = 0.012). Black women obtained their desired contraceptive plan at a comparable rate when compared to both White and other race/Biracial women of other races (p = 0.77) and changed their desired plan at similar rates (p = 0.77). We found a significant difference in prenatal CC, but not desired contraceptive plan attainment based on self-reported race. Further research needs to assess patient's satisfaction with their contraceptive counseling, including any perceived stigma or coercion. In addition, understanding why women changed their method choice from admission to discharge may inform provider education and build better patient-provider relations in the future.